宫内外同时妊娠的手术治疗及妊娠结局分析  

Surgical treatment and outcome analysis of heterotopic pregnancy

作　　者：潘秀玉 郭凯敏 赖毓冕 PAN Xiu-yu;GUO Kai-min;LAI Yu-mian(Department of Obstetrics and Gynecology,Guangzhou Women and Children's Medical Center,Guangzhou 510623,Guangdong,CHINA)

机构地区：[1]广州市妇女儿童医疗中心妇产科

出　　处：《海南医学》2019年第15期2014-2016,共3页Hainan Medical Journal

基　　金：广东省广州市卫生和计划生育科技项目(编号:20181A011036)

摘　　要：目的分析发生宫内外同时妊娠的早期诊断方法,可选择的治疗方式及妊娠结局。方法回顾性分析2000年1月到2017年12月就诊于广州市妇女儿童医疗中心确诊为宫内外同时妊娠的23例患者的临床资料,所有患者均行腹腔镜或剖腹探查术治疗,术中行患侧输卵管切除术,并收集其他临床资料。结果 23例中术后宫内孕稽留流产3例,早产4例,足月产16例;无新生儿窒息及其他母儿并发症;行患侧输卵管切除术后,继续妊娠率为86.96%(20/23),足月活产率为69.57%(16/23)。结论经阴道超声检查是早期诊断宫内外同时妊娠的重要方法;严格把握剖腹探查手术指征,熟练掌握腹腔镜手术的操作,并严密随访,其后的妊娠及生育仍可维持。Objective To analyze early diagnosis methods, alternative treatment methods, and pregnancy outcome for heterotopic pregnancy (HP). Methods Retrospective analysis was performed on 23 patients with heterotopic pregnancy who underwent laparoscopic surgery or exploratory laparotomy, and surgical salpingectomy in Guangzhou Women and Children's Medical Center from January 2000 to December 2017. And other clinical data were also collected. Results Of the 23 patients, 3 had missed abortion, 4 had premature delivery, and 16 had full-term delivery, no neonatal asphyxia or other maternal-fetal complications occurred. After the ipsilateral salpingectomy, the rate of continued pregnancy was 86.96%(20/23), and the full-term live birth rate was 69.57%(16/23). Conclusion An early transvaginal sonography (TVUS) is considered to be essential and beneficial for early diagnosis of HP. Subsequent pregnancy and childbirth could be maintained, if the indications for exploratory laparotomy are strictly controlled, the operation of laparoscopic surgery is mastered, and strict follow-up is established.

关 键 词：宫内外同时妊娠 辅助生殖技术 经阴道超声 手术治疗 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]